基于动态不确定因果图的名老中医辨治模型构建与应用——以朱仁康湿疹医案为例OA

Objective Based on the theory of the Dynamic Uncertain Causality Graph(DUCG),this study aims to construct an intelligent diagnostic model encapsulating the clinical experience of the renowned traditional Chinese medicine(TCM)dermatologist,Dr.Zhu Renkang,in the diagnosis and treatment of eczema.This paper explores the utility of DUCG in the preservation of distinguished veteran TCM practitioners'expertise,specifically focusing on improving the accuracy of syndrome differentiation,visualizing dialectical thinking,and enhancing interpretable reasoning.Methods Relevant books,literature,and medical records of Zhu Renkang were systematically reviewed to extract and obtain 18 common TCM syndrome types,71 symptoms and signs,and 8 categories of risk factors related to eczema;these key information and data were mapped into DUCG logical variables to construct a DUCG model for eczema pattern differentiation.A database of eczema medical cases personally treated by Zhu Renkang was compiled,from which 30 cases were randomly selected for model parameter calibration and optimization to improve diagnostic precision.The optimized DUCG model was used to conduct three rounds of syndrome verification on 120 independent test cases,and a comparative analysis was conducted with the general large language model(LLM)ChatGPT 5.1,DeepSeek-R1,the TCM specialized LLM Huatuo GPT Ⅱ,and three clinicians of the same school with different levels of clinical expertise.Results The diagnostic accuracy of the DUCG model was 78.33％,higher than the average level of doctors(72.50％),ChatGPT 5.1(37.50％),DeepSeek-R1(33.06％),and Huatuo GPT Ⅱ(28.61％).In terms of stability,the results of the DUCG model in three rounds were consistent,with a standard deviation of 0,which was superior to LLMs and the doctor team.Meanwhile,the subgraphs of each syndrome type and the simplified pathogenesis diagrams of DUCG can clearly display the diagnostic basis and reasoning path,achieving complete interpretability.Conclusion The DUCG diagnostic model for Zhu Renkang's eczema constructed in this study has demonstrated advantages in terms of accuracy,stability and interpretability,providing an effective solution for the visual interpretation,structured preservation and intelligent inheritance of the experience of renowned TCM practitioners.